Exploring Practice Patterns of Pediatric Telerehabilitation During COVID-19: A Survey Study

Abstract

Background and Objective: Sudden transition to telerehabilitation during the coronavirus disease 2019 (COVID-19) pandemic was challenging for pediatric therapists, including physical therapists and occupational therapists, due to lack of prior experience and knowledge. The primary goal of the current study was to survey the pediatric therapists regarding the practice trends and specific challenges/strengths of delivering telerehabilitation during the pandemic. Materials and Methods: An electronic survey was developed by the research term and validated through cognitive interviews with three pediatric therapists. A total of 107 therapists completed the survey. Descriptive statistics were used to summarize the trends for the survey questions. Results: The majority of therapists (92.5%) reported no prior experience with telerehabilitation. When comparing telerehabilitation with standard-of-care, the therapists reported similar session durations and frequencies, but greater caregiver-initiated cancellations of telerehabilitation sessions. Furthermore, a greater percentage of therapists modified the intervention activities compared with assessments, which impacted therapists' perceptions about quality of telerehabilitation as a greater percentage of therapists expressed confidence in treating children compared with assessing children virtually. One of the commonly reported telerehabilitation challenges was reduced virtual engagement of children, and strength was better assessment of home environment. Lastly, a greater percentage of therapists relied on consultations and fewer therapists used empirical evidence to guide their delivery of virtual care. Conclusions: Telerehabilitation is a cost-effective health care model that offers remote accessibility and flexible scheduling. However, several limitations in the current pediatric telerehabilitation model, including lack of teleassessments and empirical evidence, could limit post-COVID use of telerehabilitation.

Exploring virtual care clinical experience from non-physician healthcare providers (VCAPE)

“…Survey data from an integrated medical health care system in West-Central Florida suggests that the providers were satisfied with video than telephone and felt comfortable and satisfied with virtual care ( Wright, Dewan, Hilty, & Dewan, 2020 ). Survey data on the experience of Pediatric therapisits (PT, OT) delivering virtual care shows that the participants did not deliver equivalent care and also lacked knowledge, training and resources ( Kaur, Eddy, & Tiwari, 2022 ). The first phase of Kotter's change management theory is ensuring a climate of change which includes building a strong team to help create and support the vision for change created by the COVID-19 crisis.…”

Barriers to Video Call–Based Telehealth in Allied Health Professions and Nursing: Scoping Review and Mapping Process

“…Most articles covered barriers for PTs (29/56, 52%) [43,48,49,[51][52][53][55][56][57]59,[61][62][63][64][65]67,74,[76][77][78][79][80][81][82]84,85,87,92,95], followed by those for SLTs and audiologists (18/56, 32%) [29,48,50,52,[59][60][61]73,[79][80][81]83,85,[92][93][94]96]. Furthermore, publications were concentrated on OTs (15/56, 27%) [45,47,52,[60][61]…”

Exploration of the Feasibility of Remote Assessment of Functioning in Children and Adolescents with Developmental Disabilities: Parents’ Perspectives and Related Contextual Factors

“…This is because social distancing has brought with it extensive changes in the lives of families, with particular potential impact on many domains of functioning at the same time [ 3 ]. The protective measures undertaken, such as social distancing and interruption of face-to-face activities [ 4 , 5 , 6 , 7 , 8 ], more than preventing the spread of the COVID-19, interrupted a series of therapies and other activities to promote the development of these children. Thereafter, countless families with children and adolescents presenting developmental disability were left out by the impossibility of continuing therapeutic care or face-to-face guidance for follow up [ 5 , 9 ].…”

“…Remote health care involves both patients’ evaluation and intervention. Nevertheless, the implementation of remote care programs occurred despite the lack of specific technical directions addressing physical security of the patients, the confidentiality of their data, and ethical aspects involving virtual data management and other investigations about the feasibility of the processes used in remote assessment [ 4 , 5 , 9 , 12 , 13 ]. In this way, for telehealth strategies for children with disabilities to be well targeted and reliable, it is important that remote assessments are effective, and parents feel comfortable with this kind of approach.…”

“…Remote assessment reduces barriers and allows broad access to monitoring the development of children, expending lesser financial resources [ 4 , 5 , 11 , 12 , 17 , 18 ]. However, it is necessary to first investigate the feasibility of a remote assessment of children’s health conditions under the light of the biopsychosocial model, considering parents’ perspectives of this evaluation, then ensuring family-centered care and direct involvement of parents in care-taking, listening to their needs, and establishing a partnership between family and therapists [ 10 ].…”